AIM: To explore the experiences of Emergency Department nurses when caring for patients presenting to the Emergency Department with mental health issues. DESIGN: Qualitative descriptive study. METHODS: Ten nurses with experience caring for mental health patients participated in face-to-face, semi-structured interviews. Nurses were recruited if they were employed at a single tertiary Emergency Department in the Northern Territory, Australia. Interviews were audio-recorded, transcribed, and analysed using thematic analysis. The COREQ checklist guided reporting. RESULTS: The four key themes were: systemic factors; emotional impact and staff culture; influence of communication; education and training. Systemic factors, such as overcrowding, staff shortages, long stays, and unsuitable Emergency Department environments, restricted therapeutic care and increased patient distress. The emotional impact of caring for mental health patients, combined with reactive workplace culture and stigma, contributed to moral distress and burnout. Clear communication and teamwork supported care, while limited mental health education left nurses underprepared and reliant on informal learning. Participants emphasised the need for clear protocols, targeted training, and structured support to enhance patient outcomes, nurse confidence, and well-being. CONCLUSION: Emergency Department nurses face systemic, cultural, and educational barriers that compromise patient care while contributing to stress, fatigue, and burnout. Addressing these challenges through integrated care pathways, targeted education, and staff support is essential to improve patient outcomes and sustain the nursing workforce. IMPLICATIONS FOR PRACTICE: Data from this study identifies there is an urgent need to implement practical strategies to reduce challenges for nurses in caring for patients presenting to the ED with mental health issues. IMPACT: This study revealed that systemic pressures, emotional fatigue, and limited training hinder effective care. This research can inform hospital leaders, policymakers, and educators to improve support, training, and care pathways within ED settings. REPORTING METHOD: The authors have adhered to the COnsolidated criteria for REporting Qualitative research (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was made.
Kent et al. (Sun,) studied this question.